Lawrence v. Mountainstar Healthcare

Rule of Law:

Under Utah's 'apology statute,' expressions of apology, sympathy, or offers to pay medical expenses made by a healthcare provider after an unanticipated medical outcome are inadmissible to prove liability; however, direct admissions of fault are not protected by the statute and are admissible.

Facts:

• On January 22, 2007, Jonna M. (Shannon) Lawrence went to the emergency room at St. Mark's Hospital for an allergic reaction to Tylenol 3.
• Dr. Paradise prescribed several medications, including epinephrine, which was ordered to be administered subcutaneously (under the skin).
• A nurse mistakenly administered all of the medications, including the epinephrine, intravenously (into the vein).
• Immediately after the intravenous injection, Shannon cried out in pain, her back arched off the bed, she vomited, and she experienced heart palpitations.
• During her hospitalization, hospital administrators, risk managers, and Dr. Paradise acknowledged to Shannon and her family that an error had been made, apologized, and made statements like 'we will take care of all of it.'
• While still hospitalized, Shannon contacted her family attorney.
• Shannon was discharged within a week but subsequently complained of ongoing serious medical conditions, including anoxic brain damage, cardiac damage, and chronic pain, which she attributed to the injection error.
• On July 4, 2011, years after the hospital incident, Shannon was found in possession of a plastic pen straw with opiate residue.

Procedural Posture:

• Shannon filed a negligence complaint against the Hospital in trial court.
• The parties entered a joint stipulation agreeing that the Hospital breached the applicable standard of care, but the Hospital denied that this breach caused any damages.
• The trial court ordered that only the issues of causation and damages would be submitted to the jury.
• Prior to trial, the court granted the Hospital's motion to exclude statements of apology and offers to pay medical expenses but denied Shannon's motion to admit them as admissions of fault.
• The trial court also ruled to admit evidence of Shannon's early contact with her attorney and limited evidence of her possession of drug paraphernalia, while excluding evidence of the Hospital's internal risk management activities.
• At the close of evidence, Shannon moved for a directed verdict on causation, which the trial court implicitly denied.
• The jury returned a verdict in the Hospital's favor, finding that its breach of the standard of care was not a cause of Shannon's injuries.
• Shannon filed a motion for judgment notwithstanding the verdict and a motion for a new trial, both of which the trial court denied.
• Shannon (appellant) timely appealed the trial court's judgment to the Utah Court of Appeals, arguing against the evidentiary rulings and the sufficiency of the evidence.